Anorectal Malformation in Females - Dr. Bhavesh Doshi, Pediatric Surgeon

Case No. 23: Anorectal Malformation in Females

• It might be a Perineal fistula, Vestibular fistula, Persistent Cloaca ( common channel less than or more than 3cms), or imperforate anus without fistula or rectal atresia.
• Where the anal opening is not present, diagnosis is done by Cross table lateral pronogram (to access the level of the fistula). It should be performed 18-20 hours after the birth of the child.
• In Recto vestibular fistula (most common in females), a small opening is present at the posterior fourchette of the vestibule. The child can be kept on regular rectal washes until the child is 4 kgs or 2-3 months of age.
• Primary PSARP can be performed as a single staged procedure or a PSARP with colostomy can be performed.
• Anal dilatation program should be followed for 1 year after the procedure.
• Generally, the child is continent and gives very good results post the procedure.